CMS Price Transparency Data

Culture, blood

Facility: Pulaski Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $91
Cash Discount Price: $196
vs. Medicare Baseline: 8.82x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Pulaski Memorial Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $196. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 8.82x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$196

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$10.32

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.32 (100%)

Cash / Self-Pay: $196 (1899%)

Insurance Median: $91 (882%)

Cash: $196 (1899% of Medicare)

Ins. Median: $91 (882% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $10.32 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 882% of the Medicare baseline (a markup of 782%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$10 - $186	97%
Caresource Mcaid Hhw	$10	97%
Cenpatico Mcaid Hhw - All Other Plans	$10	97%
Mdwise Mcaid Hcc	$10	97%
Mdwise Mcaid Hhw	$10	97%
Mhs Mcaid Hhw/Hcc	$10	97%
UnitedHealthcare	$10 - $221	97%
Ambetter / Centene	$87	843%
Caresource Mcaid Hip	$87	843%
Caresource Mcare Hmo	$87	843%
Cenpatico Mcaid Hip	$87	843%
Humana	$87 - $225	843%
Mdwise Mcaid Hip - All Other Plans	$87	843%
Mhs Mcaid Hip	$87	843%
Mhs Mcare Allwell	$87	843%
Aetna	$101	979%
Caresource Exch Hmo Hix - All Other Plans	$108	1047%
Sagamore Rose Acre	$208	2016%
Sagamore - All Other Plans	$211	2045%
Encore Ppo - All Other Plans	$237	2297%
Community Health Alliance - All Plans	$249	2413%
Encore Workers Comp	$251	2432%
Multiplan - All Plans	$251	2432%
Cigna	$265	2568%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $196.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87040.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Pulaski Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87040.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.